Sudden high sugars

[starlightrays]

Hello,

I was diagnosed with type 2 diabetes when I was 14 and I'm now 27. After lurking on these forums a lot last year I decided enough was enough with my poor diabetes control and started a low carb diet of around 30g of carbs a day. For the last couple of months my readings have all been within 5-8 range, mostly 6s and 5s which has been amazing. I did get a bit sick in December due to my stomach rejecting PPI medications I took for GERD which resulted in a fair amount of hypos, but that all stopped by stopping the pills, and I find I can get away with some Gaviscon every couple of days right now.

I did "cheat" on my diet on Christmas day (the 25th only), and had some raised levels (10-11) afterwards, but was seeing the familiar 6s and 5s again within 2 days so I thought all was okay (I know many disagree with doing this but since this is new to me I wasn't quite ready to go "cold turkey" for one day). But since 1st January my bloods have consistently been high, in the 8-11 range. This is unusual because even when I first started this diet my blood sugars fell within days, but these high 8s 9s and 10s are sticking around very consistently for a week now.

I take 320mg of Gliclazide and 25mg of Alogliptin daily. There have been no other lifestyle or medication changes. For breakfast I'll have scrambled egg made with double cream and two slices of "seriously low carb" keto bread, which is 1g carbs per slice. I don't tend to have lunch but can find my sugars lower with 3 "meals" vs. 2 so might have some pate, low carb sliced meats or a DGF cookie (these are keto and have never bothered my sugars prior). For dinners I'll have some low carb meat with 4.4g worth of salad and around 6g of green vegetables. It comes to between 23-30g a day and I currently used a lot of pre-packaged things so I know I'm not miscalculating.

I have spoken to my diabetes nurse today obviously upset about the situation and she doesn't really have any answers. She does want me to have genetic testing and I am due to see a consultant at the hospital on the 20th but have had very negative experiences of being told I'm "lying" about my initial test results (of being diagnosed at 14) in the past there so I'm not looking forward to it but of course am determined to get my sugars down. I've just been diagnosed with gum disease despite having good dental hygiene habits which is no doubt due to raised sugars in the past along with me having autoimmune conditions like uveitis and psoriasis (inflammation). I don't think this would be the cause of the recent spikes though as my gums have been inflamed for a couple of years now. My nurse has mentioned MODY and that I seem to fit the profile for Lipodystrophy, but since we've failed to get me further testing in the past I can't offer much more there.

I know nobody can offer me medical advice but I was wondering if anyone else has dealt with sudden consistent increases of blood sugar for no reason they can think of. I'm not due a cycle and never see raised sugars with them anyway and it confuses both me and my diabetic nurse as to why what worked just a week or so ago doesn't work right now. All she could say is perhaps I'm fighting off an infection I'm not aware of but as I care for someone vulnerable I shield so doubt I have COVID currently and feel well. I apologize for the length of this but I didn't want to leave any details out. I did take insulin in the past but it didn't seem to lower my sugars very well and gave me terrible GERD symptoms.

 

[ianf0ster]

Any infection is likely to raise your BG while your body fights it - not just Covid.
As is stress, lack of sleep, an injury or operation, medication including Steroids and Statins and a host of other things (I have heard its as many as over 40 in total).
You have a BG monitor, so control what you can - which is mainly your meals.
You don't say whether you are actually measuring before each meal and then 2hrs after first bite. If you are and are getting a BG rise of 2 mmol or less, then that means that A). your meals are OK for you and B) You are a Type 2 not anything more exotic so there must be some other reason for your fasting BG a sort of base/background level to be so high. If the glucose isn't coming from your food, then your liver is producing it and there must be a reason for that to be happening.

Oh and if it is the liver dumping more glucose, then don't worry, temporary levels of 10 to 11 mmol aren't that bad !

I still have some Dawn Phenomenon even after 2 yrs in remission it varies a bit and is trending down - but very slowly.
I also has a urine infection which took more than 1 course of antibiotics to cure and that caused me sleepless nights due to trips to the loo. This raised my fasting BG and thus raised my post meal BG too. It was even long enough to be reflected in my HbA1C , but since I knew the cause it didn't concern me.

 

[VashtiB]

Hello and welcome,

I am sorry you are having such a difficult time. It is extremely frustrating to not be able to get the levels down. So just a couple of things from me. As @ianf0ster commented above there are lots of things that can contribute. I find that stress, anxiety and lack of sleep contribute. I also find that some artificial sweeteners pack a real punch totally disproportionate to the listed amount of carbs.
Given you are taking medication be very careful of any changes.

I also sympathise with the medical profession assuming you are stupid or lying. That has certainly happened to me. It's funny how differently they respond when my (very slim) husband confirms what I have said.

Good luck and let us know how you get on.

 

[finzi1966]

All I can contribute, without attempting to “diagnose” you, is that it seems like maybe you don’t have straightforward type 2 diabetes. Sugars like you are describing just seem excessively high for a type 2 on such a low carb diet, especially when you are on such a substantial dose of gliclazide. And, significantly, that you were very recently still having sugars in the 5s and 6s. It is of course also possible that you have an infection brewing, whether covid or something else?

I really feel for you, it must be terribly distressing to experience high blood sugars for no apparent reason and without being able to lower them. I hope they can find a solution for you. One thing I really feel certain of: this is NOT your fault because you ate an indulgent Christmas dinner. It doesn’t work like that.

 

[starlightrays]

You don't say whether you are actually measuring before each meal and then 2hrs after first bite. If you are and are getting a BG rise of 2 mmol or less, then that means that A). your meals are OK for you and B) You are a Type 2 not anything more exotic

I was testing three times a day but generally after meals. So I've started testing before and 2 hours after my meals and have noticed a much larger spike than I expected. Yesterday my fasting bloods were 7.0 and 2 hours after eating my usual scrambled eggs they were 12.0. Then before dinner they were 8.8 and after dinner (burger 2.5 carbs, green veg and salad) they were 12.5.

If this means I'm not tolerating my meals I'm afraid I don't know how to reduce my carbs further or eat less and my diabetic nurse agreed with this. I've cut out any "lunch" completely. I know I could go lower than 30g carbs daily but because of my GERD I cannot tolerate greasy or fried foods which I find makes this harder.

 

[ianf0ster]

Depending if you put anything in them, scrambled eggs could be almost zero carbs (less than 0.5 gms unless you add toast etc). a rise of 5 mmols for a zero carb meal is huge!
Doesn't seem like just ordinary Type 2 insulin resistance to me.
Tell your GP or Diabetic nurse about your readings before and after meals.
I would push to get some tests for Type 1/ LADA

 

[starlightrays]

Depending if you put anything in them, scrambled eggs could be almost zero carbs (less than 0.5 gms unless you add toast etc). a rise of 5 mmols for a zero carb meal is huge!
Doesn't seem like just ordinary Type 2 insulin resistance to me.
Tell your GP or Diabetic nurse about your readings before and after meals.
I would push to get some tests for Type 1/ LADA

I make my scrambled eggs with double cream not milk to avoid the carbs, and I have two slices of Seriously Low Carb Loaf which claims to be 1g a slice. I am keeping them well informed but neither of those have been mentioned as a possibility. My mother is also a type 2 which I assume means that type is genetic for us. I also don't suffer with hypos generally (Only in December because of a serious upset stomach and being low carb and on Gliclazide combined). Today my blood went up 3 points after breakfast and 2 points after dinner which is slightly improved (still in the 8-11 range), but I'm not very hopeful yet.

 

[ianf0ster]

You have plenty of scope to reduce the carbs in that breakfast. Scramble eggs in a non stick pan , no cream, no bread. See what figures you get from that. A meal like that should not raise Blood glucose by anything much and could even reduce it (it does with me in a morning because it tells my liver I don't need energy to go hunt/gather my next meal like a caveman. Otherwise I get higher readings in morning due to Dawn Phenomenon.
It makes it more difficult for us when you only list part of the tings you eat. Although your meal may be as low carb as you think, if you miss something out like bread, fruit etc (even low carb ones) , fruit juice it can through out our calculations of what is a normal T2 response.

 

[starlightrays]

It makes it more difficult for us when you only list part of the tings you eat. Although your meal may be as low carb as you think, if you miss something out like bread, fruit etc (even low carb ones) , fruit juice it can through out our calculations of what is a normal T2 response.

To quote my original post, "For breakfast I'll have scrambled egg made with double cream and two slices of "seriously low carb" keto bread, which is 1g carbs per slice." I did not leave it out and don't appreciate the assumption. Yesterday I had a couple of slices of meat listed as <0.5g per slice with some cheese and found my bloods still went from 8.11 to 11.9 and I got hungry which isn't usual for me. I am still new to this. Today I will cut out the cream and the bread, and I already use a non stick pan.

 

[ianf0ster]

Sorry for any offense. As you probably realise I read and respond to tens of posts per day across both UK diabetes forums, so although I try to re-read posts so as not to miss important things, sometimes I do miss details.

 

[starlightrays]

I decided to fast today (still taking medication) to see what would happen. My fasting result was 9.1 and even with only drinking water all day it's gone up to 10.2

 

[mouseee]

I think it would be a really good idea to keep a food diary and write down all your BGs before and after eating.
It does sound like you need to somehow convince your dr or diabetic nurse to investigate what's happening and they are bound to ask for one.
I communicate with our drs with the app we can use and I've found that really useful as I can really explain things clearly. In fact, that's how I got my t2 diagnosis. I laid out all the symptoms and the BG I had from my mums monitor. It was such a good way to explain things ad you can take your time writing it rather than having just 10 minutes in and out of the room

 

[starlightrays]

I think it would be a really good idea to keep a food diary and write down all your BGs before and after eating.
It does sound like you need to somehow convince your dr or diabetic nurse to investigate what's happening and they are bound to ask for one.

I've been keeping a notebook of all my carb intake and blood sugars since the start of November, but admit I made the mistake of only testing before meals, but am now doing before and 2 hours after. My nurse is calling again on the 18th but never really has much to offer, sadly. But that's a good idea and I think I will also write down my concerns beforehand.

 

[coby]

I've been keeping a notebook of all my carb intake and blood sugars since the start of November, but admit I made the mistake of only testing before meals, but am now doing before and 2 hours after. My nurse is calling again on the 18th but never really has much to offer, sadly. But that's a good idea and I think I will also write down my concerns beforehand.

If your nurse is not showing enough interest how about typing out a letter with all your own findings/tests/food intake, to your GP (addressing For The Attention Of) to make certain only he/she opens it ?

 

[starlightrays]

If your nurse is not showing enough interest how about typing out a letter with all your own findings/tests/food intake, to your GP (addressing For The Attention Of) to make certain only he/she opens it ?

My nurse did try and get me to the hospital for tests in 2020 but I believe maybe due to the doctor leaving or funding it stopped being an option we could take (but it was never really explained clearly to me when I asked, they do avoid that!) I don't really have a set GP because mine left and appointments are mostly done with nurse practitioners now, but I have a consultation at hospital on the 20th (if it doesn't get cancelled again) where I'm going to bring up the potential of further testing. It's just frustrating to see these high numbers in the mean time.

 

[Ronancastled]

Greetings @starlightrays
I've read through all the above & owing to your age at diagnosis & the fact you've got low carb figured out I would push for those GAD, antibody tests to rule out variations of T1.

 

[starlightrays]

Just as I was writing this post to update that thankfully my sugars have fallen back into the 4-7 range (with no diet changes so unsure as to why it's happening still), the hospital rang to cancel my appointment tomorrow. Again. I explained to the secretary how my diabetic nurse has been trying to get me these tests since 2020 and she said she'll pass it on, but I'm not sure what good that'll do.

 

[lessci]

I'm not sure if it's still going, but Freestyle were doing a free Libre 2, (CGM) if you've got a smartphone you just download the app. 2 weeks worth of reading could be invaluable

 

[GowP]

I am having the same issue. Good to see that yours has been resolved. I was seeing FBG in the range of 5.4 to 6.5 in the mornings but suddenly this has risen to up to 8.3. No changes in food etc - maybe some change in stress levels. Trying to see what I can now do to bring this down. For background - I did the Newcastle diet for 6 weeks and then switched to low carb.

 

[starlightrays]

My morning sugars have risen from 5 to 8, despite them usually being 6 two hours after my dinner, and me not eating anything after or making any changes to my diet (been eating the same meals since new year because of this issue). I know food is far from the only factor. My new hospital appointment is in March if it also doesn't get cancelled. I've noticed even when I fast my sugars can rise. A bit fed up, I know this is a marathon not a sprint but when GPs talk like it's your fault (and refuse to look into any other issue because I'm diabetic) it's frustrating.